Peritonitis

Ketone Administered into the peritoneal cavity LD q, mouse, mg/kg Adrninistered under the skin LD q, mouse, mg/kg... 

The principal arninoglycoside toxicides are neuromuscular paralysis, ototoxicity, and nephrotoxicity. Neuromuscular paralysis is a relatively rare complication resulting from high aminoglycoside concentrations at the neuromuscular junctions following, for example, rapid bolus intravenous injection or peritoneal instillation, rather than the normal intravenous infusion. The mechanism apparentiy involves an inhibition of both the presynaptic release of acetylcholine and the acetylcholine postsynaptic receptors (51). 

Poly(ethylene carbonate). Like polyesters, polycarbonates (qv) are bioabsorbable only if the hydrolyzable linkages are accessible to enzymes and/or water molecules. Thus pellets of poly(ethylene carbonate), ( OCOOCH2CH2 )n weighing 200 mg implanted ia the peritoneal cavity of rats,... 

Extravasation of barium sulfate iato the peritoneal cavity through a perforated GI tract can produce serious adverse reactions. When a perforation is suspected, the use of a water-soluble iodinated contrast medium is iadicated. In this case, oral or rectal administration of sodium or meglumine-sodium salts of diatrizoic acid (6) and oral use ofiohexol (11) are the preferred procedures. 

The relative toxicities of thallium compounds depend on their solubHities and valence states. Soluble univalent thallium compounds, eg, thaHous sulfate, acetate, and carbonate, are especiaHy toxic. They are rapidly and completely absorbed from the gastrointestinal tract, skin peritoneal cavity, and sites of subcutaneous and intramuscular injection. Tb allium is also rapidly absorbed from the mucous membranes of the respiratory tract, mouth, and lungs foHowing inhalation of soluble thallium salts. Insoluble compounds, eg, thaHous sulfide and iodide, are poorly absorbed by any route and are less toxic. 

Mansonellaperstans adult worms five encysted in various peritoneal tissues (eg, pericardium, pleura, and peritoneum). Af. perstans microfilariae are not affected by diethylcarbama2ine but mebenda2ole has been successful in treating Af. perstans filariasis (33). 

Fig. 7. Estimate of the total number of patients receiving maintenance dialysis over the past 20 years. Totals include both hemodialysis and peritoneal dialysis, but exclude transplant recipients. The fraction of patients receiving peritoneal dialysis has grown steadily from 0% in 1978 to about 12% in 1992. These data were combined from various regional registries and industry sources demographic estimates of this iLk are accurate to within 5% (46). D,...

R. Gokal, Continuous Ambulatoy Peritoneal Dialysis, Churchill Livingston, Edinburgh, 1987. 

K. D. Nolph, Peritoneal Dialysis, 3rd ed., Martinus Nihjoff, The Hague, 1988. 

Mice are utilized for testing antiseptics for appHcation to cuts, wounds, and incisions (339). The test bacteria, type 1 pneumococcus and hemolytic streptococcus, ate appHed to the taHs of anaesthetized mice. The tip of the taH is then dipped into the antiseptic for 2 min, after which one-half inch of the taH is removed and inserted into the peritoneal cavity and the incision is closed. If after 10 days the animals survive, the product is considered satisfactory for use as a skin antiseptic. The blood of dead animals is sampled and streaked on blood agar for confirmation of infection from the test bacteria as the cause of death. Since lack of toxicity is another requirement of a product to be appHed to wounds, this test has been combined with a toxicity test (340). 

Ascites. Patients with cirrhosis, especially fiver cirrhosis, very often develop ascites, ie, accumulation of fluid in the peritoneal cavity. This is the final event resulting from the hemodynamic disturbances in the systemic and splanchnic circulations that lead to sodium and water retention. When therapy with a low sodium diet fails, the dmg of choice for the treatment of ascites is furosemide, a high ceiling (loop) diuretic, or spironolactone, an aldosterone receptor antagonist/potassium-sparing diuretic. 

In an animal study of rats exposed by inhalation to ethylene oxide at 10, 33, or 100 ppm for approximately two years (245), and in a separate chronic rat study in which rats were exposed to 50 or 100 ppm of ethylene oxide (240), increased incidences of mononuclear cell leukemia, peritoneal mesothelioma, and various brain tumors have been reported. In an NTP (246) two-year inhalation study of mice at 50 and 100 ppm, alveolar/bronchiolar carcinomas and adenomas, papillary cystadenomas of the harderian gland, and malignant lymphomas, uterine adenocarcinomas, and mammary gland tumors were increased in one or both exposure groups. 

Chloro-oxazolo[4,5-/i]quinoline-2-carboxylic acid methyl ester was the most active compound in tests for inhibitors of antigen-induced release of histamine in vitro from rat peritoneal mast cells (IC50 of 0.3 p,M) and as inhibitors of IgE-mediated passive cutaneous anaphylaxis in the rat (ED50 (intraperitoneal) of 0.1 mg/kg in dose 0.5 mg/kg as an inhibitor of the test)—10 times and 60 times more potent, respectively, than the disodium salt of cromoglycic acid (85JMC1255). 

Toxicity. A 1% concn of the gas in air is lethal to rats in 1 hour, its effect being similar to C monoxide the LD50 in rats when injected intra-peritoneally is 8.2ml/kg (Ref 16). Earlier workers assumed that the toxicity of N trifluoride would be similar to H fluoride and that the latter would be formed by hydrolysis in body tissues (Ref 1). This has recently been shown to be erroneous, and that it is stable under physiological conds. The toxic effect is due to its ability to complex with the hemoglobin of the blood causing anoxia. This effect is reversible, and animals receiving a sublethal dose recover rapidly upon removal from contact with N trifluoride (Ref 14)... 

The adverse reactions associated with the menotropins include ovarian enlargement, hemoperitoneum (blood in the peritoneal cavity), abdominal discomfort, and febrile reactions. Urofollitropin administration may result in mild to moderate ovarian enlargement, abdominal discomfort, nausea, vomiting, breast tenderness, and irritation at the injection site Multiple births and birth defects have been reported with the use of both menotropins and urofollitropin. 

In severe cases, or those refractory to treatment, truncal and limb weakness may be accompanied by involvement of masticatory, bulbar, and respiratory muscles. However the most life-threatening clinical manifestations are those affecting the gastrointestinal tract, since stomach ulceration can occur and death from perforation and peritonitis are not unknown. Medication with steroidal antiinflammatory agents is necessary but weakens the childrens resistance to infection, so that systemic spread of usually self-limiting disorders, such as candidiasis, may occasionally occur. 

Rabbit peritoneal neutrophils were harvested and their release of p-glucuronidase was measured at 37°C, as described previously (13). For indo-1, neutrophils were washed twice in a calcium-free buffer, then loaded with 15 indo-1 acetoxymethyl ester (24) for 40 min at 37 C at a density of 5 x 10 cells/ml. The cells were then washed twice more in calcium-free buffer, resuspended to a density of 1 X 10 cells/mL, and kept on ice. Prior to fluorometry, cells were diluted 4x with the appropriate buffer at 37 C. For CTC, neutrophils were incubated with 20 pH CTC at 37°C in the spectrofluorometer cuvette. All measurements were carried out using an SLH-Aminco SPF 500C fluorospectrometer interfaced with an IBM PC microcomputer. 

While all species lost body weight following treatment with 2,3,7,8-TCDD, other signs of toxicity were species dependent. Ascites was seen in mice. Anorexia, dehydration, depression, emaciation, intestinal hemorrhage, and alopecia were seen in dogs. Certain rabbits treated intra-peritoneally with 2,3,7,8-TCDD developed skin lesions typical of those associated with acnegens. 

The gross lesions seen in chicks treated with chlorodibenzodioxins are summarized in Table VI. The most consistent gross lesions were increased pericardial and peritoneal fluid, subcutaneous and pulmonary edema, hepatomegaly, and a mottled appearance of the liver. 

Muramyl dipeptide derivatives have also been microencapsulated in lactide/glycolide copolymers for use alone as an immuno potentiator. L-lactide/glycolide copolymers were used to deliver MDP-B30, a lipophilic compound, from very small microspheres (less than 5 pm in diameter). The amount of MDP-B30 required for tumor growth inhibitory activity of mouse peritoneal macrophages was 2000 times less for the controlled release MDP-B30 microspheres than for the unen-capsulated drug (134). 

Intraperitoneal administration of chemotherapeutic agents has been used for many years as a way of increasing the delivery of drugs to tumors (e.g., ovarian carcinoma) located in the peritoneal cavity (Markman, 1986 Howell and Zimra, 1988). Cisplatin (Casper et al., 1983 Markman et al., 1985), cytosine arabinoside (Ara-C) (King et al., 1984 Markman et al., 1985, 1986), and bleomycin (Markman et al., 1986) are examples of intraperitoneally administered drugs which were already successfully applied in clinical settings. 

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